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County health officials consider policy changes as area hospitals reach capacity

Jonathan Riley

PITTSBURG, Kan. — With area medical facilities reaching their capacity for coronavirus patients, Ascension Via Christi Hospital announced this week it is halting elective and non-emergent procedures and the Crawford County Commission called a special meeting to discuss additional measures to mitigate the spread of COVID-19.

“The decision was made to pause elective and non-emergent procedures due to the recent increase in COVID-19 cases in Crawford and Bourbon counties,” Ascension Via Christi President Randy Cason said in a press release. “Hospital leaders met today and agreed that activating the surge plan that we developed this past spring was our best course of action.”

The surge plan allows the hospital to reallocate staff from other departments to assist with a patient influx.

The Crawford County Commission meanwhile held a special meeting Tuesday — after calling off a regularly scheduled meeting last week that would have been at the same time but was cancelled because of Columbus Day — to discuss recent concerning local developments in the coronavirus pandemic.

“So when we started this a few months ago one of the things that we told you that we would tell you about is if there is a hospital capacity issue,” said County Public Health Officer Dr. Tim Stebbins, who was participating in the meeting remotely. “We have that now.”

In its release, Via Christi noted that its first priority is the safety of its patients and associates.

"We are fortunate to have close relationships with our sister hospitals in Wichita and Manhattan who may be called upon to help provide additional clinical support and resources,” Cason said.

Stebbins said Tuesday, though, that the local problem was “further exacerbated by the fact that the regional players that we would typically utilize for ICU capability, including Mercy and Freeman in Joplin, are also full and are unable to take our critical care cases. And so then we have to try to go to other places, including KU and the hospitals in Kansas City and/or Springfield. They are also full, and that makes for a significant challenge.”

While the spread of COVID-19 to vulnerable populations in local long-term care facilities has been a concern, those facilities have generally been doing a good job of taking safety measures to mitigate the spread of the virus, Deputy Crawford County Public Health Officer Dr. Linda Bean said.

But the county has now reached the level of “community spread,” she said, where COVID-19 is widespread enough in the area that it can be difficult to trace where a specific patient contracted it. Bean and Stebbins emphasized the need for people with symptoms to get tested, and for those who have tested positive to inform the health department of their contacts.

As of Tuesday, Crawford County was reporting 117 positive COVID-19 cases in isolation and 535 of their close contacts in quarantine. There have been times in recent months when there were more positive cases in isolation and quarantine in the county, but the virus has recently been spreading more among the older, more vulnerable population. As of Tuesday, there were 21 COVID-19-positive patients at Ascension Via Christi, Stebbins said.

Up until now, Via Christi has at times been accepting patients from surrounding counties and across the state line in Missouri.

“But now we are filling up, they are filling up, and there’s going to be no place to go,” Stebbins said. “And if this continues in its current trajectory, all of those systems will be overwhelmed.”

As Via Christi noted in its press release, Stebbins also discussed the issue of cases being treated in Pittsburg from neighboring counties, such as Bourbon County. He also said that looser coronavirus restrictions in Bourbon and Cherokee counties present a problem for Crawford County.

Commissioners Jeremy Johnson and Tom Moody asked if a meeting could be set up with officials in those counties to ask them to take more restrictive measures.

“We’re allowing these other counties that are doing basically nothing to fill our hospitals, which takes away from our county constituents,” Moody said. “Would it be beneficial if we tried to get a meeting with the other counties to let them know our feelings on this? Because to me it’s bullshit that they’re doing this, and it really upsets me.”

Stebbins and Bean said a regional meeting would be a good idea, and at the end of Tuesday’s commission meeting Moody asked County Counselor Jim Emerson to work on setting one up.

“I mean I guess for me, like looking at the numbers that we have in front of us and the level of concern, I mean we’ve said all along that this is one of the major triggers of concern, right? That once healthcare is overwhelmed, we’re in a bad spot, and it seems to me like that’s where we are,” Johnson said.

“So I guess I’m hesitant to continue on this course of we’re going to tell people ‘Be smart’ when that’s what we’ve been doing for a couple of months now and here we are. Like I kind of feel like we’re at the point where we need to do something.”

Stebbins said he agreed that a change should be made, but the health department wanted to be sure it could be confident that any policy change it recommended would be effective in mitigating the spread of the virus.

Stebbins and Bean noted, for example, that they had not recommended changes at K-12 schools in the county, despite some COVID-19 cases being identified among students, because switching to a remote or hybrid learning model could have negative consequences due to children’s grandparents being the only option for taking care of them at home.

“So how much time do you think we have to kind of sit on this and wait for more input?” Johnson asked the health officers.

Stebbins and Bean said by Friday they should have a better answer for what next steps should be taken.

“I think three more days of looking at this to make sure that we’re right is more appropriate than knee-jerk reaction and limiting the community inappropriately,” Stebbins said.